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Learning About Tracheostomy Surgery

What is a tracheostomy?

A tracheostomy (say "trayk-ee-AW-stuh-mee") is surgery to put a breathing tube directly into your windpipe (trachea). This tube helps you breathe when something is making it difficult or impossible to breathe through your nose or mouth. For example, it may be done if you have throat cancer, a lung or nerve problem, trouble handling secretions, or something blocking your airway, or if you injured your mouth or neck. The terms tracheostomy, tracheotomy, and "trach" (say "trayk") are all used to talk about the surgery itself and the opening created by the surgery. The opening is also called astoma.

You may need a trach for a short time. Or you may need a trach permanently.

How is a tracheostomy done?

During the surgery, the doctor makes a few small cuts (incisions) to create an opening in your neck. Then the doctor puts a breathing tube through the opening and into your trachea. This tube, called a tracheostomy or trach tube, makes it easier for air to get to your lungs. It also helps remove mucus and other fluids from your lungs.

After the trach tube is put in, the opening may be left open or it may be made smaller around the tube with stitches or clips. If you no longer need the tube, the doctor will remove it, and you will have a small scar on your neck that fades over time.

You may get medicine so you will be asleep during the surgery. Or you may be awake, but you will get medicine so you do not feel pain. The surgery lasts about 30 minutes.

What can you expect after a tracheostomy?

After surgery, you will stay in the hospital until it is safe to go home. In some cases, the trach tube can be removed before you go home. But in many cases, you will need to go home with the trach tube still in place.

Your neck may be sore and you may have trouble swallowing for a few days after surgery. It will also feel different to breathe and speak. Most people get used to breathing through the tube in a few days. At first, it will be hard to make sounds or to speak. Your doctor or a speech therapist can help you learn to talk with your trach tube, either by closing the tube with your finger or by adding a special one-way valve to the trach tube. You may also be able to use speaking devices to help you talk. When you speak, your voice may sound deeper and scratchier than normal.

You can expect to feel better each day, but it may take at least 2 weeks to adjust to living with your trach. After a few weeks, you may be able to return to work or your normal routine. This will depend on the type of work you do, your employer, your ability to speak, how you feel, and other health problems you may have. Some people are not able to return to their previous job or routine.

Your trach tube may be sewn or tied to your skin. If you have stitches, the doctor will remove them about 1 week after your surgery. He or she may also take out your original tube and put in a new tube 5 to 10 days after surgery.

If you go home with your trach tube, it is very important to take good care of it. Caring for your trach helps prevent infections and helps keep you breathing easily. Your doctor will teach you how to take care of your trach at home.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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